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1720403553
DIANNE LONGO
FULLERTON, CA
NPI
1720403553
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207QS0010X Family Medicine, Sports Medicine
(Licence: CA 2251P0200X)
Enumeration Date
2014-03-03
Last Update Date
2014-03-03
Business Address
-- DIANNE LONGO
1319 EVERGREEN AVE APT N2
FULLERTON, CA 92835-2063
Phone number: 714-697-8359
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Mailing Address
-- DIANNE LONGO
1319 EVERGREEN AVE APT N2
FULLERTON, CA 92835-2063
Phone number: 714-697-8359
Copy
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